﻿<?xml version="1.0" encoding="utf-8"?>
<!--277 Health Care Claim Status Notification-->
<TransactionSpecification TransactionSetIdentifierCode="277" xmlns="http://tempuri.org/X12ParserSpecification.xsd">
  <Segment SegmentId="BHT" Usage="Required" Repeat="1" />
  <Segment SegmentId="REF" Repeat="10" />
  <Loop LoopId="1000">
    <Name>Individual or Organizational Name</Name>
    <StartingSegment SegmentId="NM1" />
    <Segment SegmentId="N2" Repeat="2" />
    <Segment SegmentId="N3" Repeat="2" />
    <Segment SegmentId="N4" Repeat="1" />
    <Segment SegmentId="REF" Repeat="2" />
    <Segment SegmentId="PER" Repeat="1" />
  </Loop>
  <HierarchicalLoop LoopId="2000">
    <Name>Hierarchical Level</Name>
    <Segment SegmentId="SBR" Repeat="1" />
    <Segment SegmentId="PAT" Repeat="1" />
    <Segment SegmentId="DMG" Repeat="1" />
    <Loop LoopId="2100">
      <Name>Individual or Organizational Name</Name>
      <StartingSegment SegmentId="NM1" />
      <Segment SegmentId="N3" Repeat="2" />
      <Segment SegmentId="N4" Repeat="1" />
      <Segment SegmentId="PER" Repeat="1" />
    </Loop>
    <Loop LoopId="2200">
      <Name>Trace</Name>
      <StartingSegment SegmentId="TRN" />
      <Segment SegmentId="STC" Usage="Required" />
      <Segment SegmentId="REF" Repeat="3" />
      <Segment SegmentId="DTP" Repeat="2" />
      <Loop LoopId="2210">
        <Name>Paperwork</Name>
        <StartingSegment SegmentId="PWK" />
        <Segment SegmentId="PER" Repeat="1" />
        <Segment SegmentId="N1" Repeat="1" />
        <Segment SegmentId="N3" Repeat="1" />
        <Segment SegmentId="N4" Repeat="1" />
      </Loop>
      <Loop LoopId="2220">
        <Name>Service Information</Name>
        <StartingSegment SegmentId="SVC" />
        <Segment SegmentId="STC" Usage="Required" />
        <Segment SegmentId="REF" Repeat="1" />
        <Segment SegmentId="DTP" Repeat="1" />
        <Loop LoopId="2225">
          <Name>Paperwork</Name>
          <StartingSegment SegmentId="PWK" />
          <Segment SegmentId="PER" Repeat="1" />
          <Segment SegmentId="N1" Repeat="1" />
          <Segment SegmentId="N3" Repeat="1" />
          <Segment SegmentId="N4" Repeat="1" />
        </Loop>
      </Loop>
    </Loop>
  </HierarchicalLoop>
</TransactionSpecification>